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Student Nighttime Residency Questionnaire

This document is intended to address the requirements mandated within the McKinney-Vento Assistance Act, U.S.C.A. 42 Section 11302(a). Your answers will help determine documents necessary to enroll your child quickly.

Special Ed*
Answer Required
State*
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The student live(s) with:*
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None of the BELOW apply – NO FURTHER INFORMATION REQUIRED AT THIS TIME.
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Student's Living Situation:
(Check all that may apply)
Answer Required

Please list all siblings between the ages of birth and 22 years old. Please complete a separate questionnaire for each child.

By inputting my full name below, I declare under penalty of the laws in the State of California that the foregoing is true and correct. In addition, I understand that the District reserves the right to verify the above listed residence information.*
Answer Required